Background
Methods
Setting
Who can be subject to a notification? | All registered health practitioners from 14 health professionsa
|
---|---|
Who can make a notification? | Patients or relatives, self, fellow practitioners, employers, agencies, members of the public, complaint commissioners |
When can action be taken against a health practitioner? (ss 178, 191, 196) | A Board may take action if a practitioner: |
• Has behaved in a way that is unsatisfactory | |
• Practices in a way that is unsatisfactory | |
• Has or may have an impairment | |
A Panel or Tribunal may take action if a practitioner: | |
• Has behaved in a way that constitutes unsatisfactory professional performance | |
• Has behaved in a way that constitutes unprofessional conduct or professional misconduct | |
• Has an impairment | |
What actions may be taken? (ss 178, 191, 196) | Non-restrictive actions |
• No further action | |
• Referral to another body | |
• Caution, reprimand or fine | |
Restrictive actions | |
• Undertaking from the practitioner | |
• Imposition of condition on registration | |
• Suspension or cancellation of registration |
Study design
Data collection
Measures
Analyses
Results
Notification rates
Characteristic | Number of notifications n = 8307a
| Adjusted notification rate per 1000 practitioners per yearb
| 95% confidence interval |
P valuec
|
---|---|---|---|---|
Profession | <0.0001 | |||
Doctor | 4504 | 14.5 | 13.9 to 15.1 | |
Nurse and/or midwife | 1537 | 2.0 | 1.9 to 2.1 | |
Psychologist | 473 | 7.1 | 6.4 to 7.7 | |
Pharmacist | 409 | 6.8 | 6.1 to 7.5 | |
Dentist | 910 | 20.7 | 18.9 to 22.5 | |
Other health practitioner | 474 | 4.5 | 4.1 to 5.0 | |
Age in 2010 | < 0.0001 | |||
≤ 25 | 255 | 2.6 | 2.3 to 3.0 | |
26–35 | 1334 | 4.0 | 3.8 to 4.2 | |
36–45 | 2104 | 6.4 | 6.1 to 6.8 | |
46–55 | 2594 | 8.2 | 7.8 to 8.6 | |
56–65 | 1582 | 8.5 | 8.0 to 9.0 | |
≥ 66 | 438 | 8.2 | 7.2 to 9.2 | |
Sex | < 0.0001 | |||
Female | 2938 | 4.0 | 3.8 to 4.1 | |
Male | 5367 | 8.9 | 8.6 to 9.2 | |
Practice location | 0.48 | |||
Major cities | 6343 | 6.2 | 6.1 to 6.4 | |
Inner/outer regional | 1840 | 6.0 | 5.7 to 6.3 | |
Remote/very remote | 117 | 5.9 | 4.6 to 7.2 |
Source and type notifications
Notifications N = 8307 Number (%) | |
---|---|
Source | |
Patient or relative | 2741 (33.0) |
Complaint commissioner | 2508 (30.2) |
Fellow practitioner | 1079 (13.0) |
Employer | 789 (9.5) |
Other agency | 441 (5.3) |
Self | 202 (2.4) |
Unknown | 547 (6.6) |
Issue | |
Performancea
| 3197 (38.5) |
Concerns about clinical care | 2550 (30.7) |
Poor communication | 368 (4.4) |
Concerns about medication | 145 (1.8) |
Delays in access to care | 134 (1.6) |
Conducta
| 2616 (31.5) |
Disruptive behavior | 672 (8.1) |
Improper use or management of health information | 628 (7.6) |
Non-compliance (admin/regulatory requirements/fraud) | 382 (4.6) |
Unlawful use or supply of medications | 364 (4.4) |
Unfair costs or misleading advertising | 349 (4.2) |
Breaches of boundaries | 221 (2.7) |
Healtha
| 462 (5.6) |
Mental illness | 202 (2.4) |
Drug misuse | 116 (1.4) |
Alcohol misuse | 81 (1.0) |
Physical/cognitive illness | 63 (0.8) |
Other issuea
| 572 (6.9) |
Unknown | 1460 (17.6) |
Outcomes of notifications
Predictors of restrictive action
Restrictive actions | Any regulatory action | |||
---|---|---|---|---|
Characteristic | Odds ratio (95% CI) |
P value | Odds ratio (95% CI) |
P value |
Source of notification | < 0.0001 | < 0.0001 | ||
Patient or relative (ref.) | 1.0 | 1.0 | ||
Complaints commissioner | 1.0 (0.8 to 1.4) | 1.1 (0.9 to 1.3) | ||
Fellow practitioner | 2.9 (2.2 to 3.8) | 1.9 (1.5 to 2.3) | ||
Employer | 6.9 (5.1 to 9.3) | 4.2 (3.3 to 5.3) | ||
Other agency | 5.3 (3.8 to 7.4) | 3.2 (2.5 to 4.1) | ||
Self | 4.0 (2.6 to 6.3) | 2.6 (1.8 to 3.8) | ||
Unknown | 2.2 (1.5 to 3.3) | 1.4 (1.0 to 1.9) | ||
Issue | < 0.0001 | < 0.0001 | ||
Performance: Concerns about clinical care (ref.) | 1.0 | 1.0 | ||
Performance: Poor communication | 0.5 (0.3 to 0.8) | 0.7 (0.5 to 1.0) | ||
Performance: Concerns about medication | 1.5 (0.8 to 2.8) | 2.7 (1.8 to 3.9) | ||
Performance: Delayed access | 0.2 (0.1 to 0.9) | 0.5 (0.3 to 1.0) | ||
Conduct: Disruptive behavior | 0.8 (0.6 to 1.1) | 0.8 (0.6 to 1.0) | ||
Conduct: Improper use or management of health information | 0.6 (0.4 to 0.9) | 1.0 (0.8 to 1.3) | ||
Conduct: Breaches of boundaries | 1.7 (1.1 to 2.5) | 1.8 (1.3 to 2.6) | ||
Conduct: Non-compliance (admin/regulatory requirements/fraud) | 0.5 (0.4 to 0.8) | 0.7 (0.5 to 0.9) | ||
Conduct: Unlawful use or supply of medications | 2.1 (1.4 to 3.0) | 2.7 (2.0 to 3.6) | ||
Conduct: Unfair costs or misleading advertising | 0.1 (0.0 to 0.2) | 0.2 (0.1 to 0.3) | ||
Health: Mental illness | 4.1 (2.8 to 6.1) | 2.0 (1.4 to 2.8) | ||
Health: Drug misuse | 7.0 (4.4 to 11.2) | 3.4 (2.2 to 5.2) | ||
Health: Alcohol misuse | 4.6 (2.8 to 7.7) | 2.5 (1.5 to 4.1) | ||
Health: Physical/cognitive illness | 3.7 (2.0 to 6.8) | 1.7 (1.0 to 3.0) | ||
Other issues | 1.0 (0.7 to 1.3) | 1.0 (0.8 to 1.3) | ||
Profession | < 0.0001 | < 0.0001 | ||
Doctor (ref.) | 1.0 | 1.0 | ||
Nurse and/or midwife | 1.8 (1.4 to 2.4) | 1.5 (1.3 to 1.9) | ||
Psychologist | 4.5 (3.2 to 6.3) | 2.6 (2.0 to 3.4) | ||
Pharmacist | 0.8 (0.5 to 1.4) | 3.1 (2.3 to 4.1) | ||
Dentist | 4.7 (3.5 to 6.4) | 2.4 (1.9 to 3.0) | ||
Other health practitioner | 5.3 (3.8 to 7.4) | 2.8 (2.1 to 3.6) | ||
Age in 2010 | 0.029 | 0.83 | ||
≤ 25 | 0.9 (0.6 to 1.5) | 1.1 (0.7 to 1.5) | ||
26–35 | 1.0 (0.8 to 1.3) | 1.1 (0.9 to 1.3) | ||
36–45 | 1.0 (0.8 to 1.3) | 1.1 (0.9 to 1.3) | ||
46–55 (ref.) | 1.0 | 1.0 | ||
56-65 | 1.2 (0.9 to 1.6) | 1.1 (0.9 to 1.3) | ||
≥ 66 | 1.9 (1.3 to 2.8) | 1.2 (0.9 to 1.6) | ||
Sex | 0.59 | 0.079 | ||
Female (ref.) | 1.0 | 1.0 | ||
Male | 1.1 (0.9 to 1.3) | 1.1 (1.0 to 1.3) | ||
Remoteness | 0.35 | 0.42 | ||
Major cities (ref.) | 1.0 | 1.0 | ||
Inner/outer regional | 1.2 (0.9 to 1.4) | 1.1 (0.9 to 1.3) | ||
Remote/very remote | 0.8 (0.4 to 1.7) | 0.8 (0.5 to 1.4) |